Oesophageal Atresia Research Auxiliary
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Print version
December 2004
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In This Issue |
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President's Report
Since our last newsletter the OARA committee has continued its focus on parent support. Through our established close ties with the Neo- Natal Case Managers we meet with parents of newborns at the earliest appropriate time to offer them much needed support, and confidence, in those sometimes traumatic early days. In addition, we have been providing a $50 voucher to assist with the inevitable costs associated with having a baby with special needs. Our Family Days continue to provide an excellent opportunity for parents to meet others with OA/TOF children in the 1 to 5 year age group. The enthusiastic response from those attending will ensure such days continue on a regular basis.
The Nate Myer's Oesophageal Atresia Data Base is to be enhanced to expand its capabilities and we are working closely with the RCH to ensure completion and intend exploring any research funding opportunities this unique historical record offers. We thank the RCH Department of Surgery for their assistance and commitment to this project.
Our co-founder, Nate Myers passed away on 7th January 2004. His funeral was attended by family and a large number of his medical colleagues. OARA was represented by a number of former and present committee members. The RCH held a memorial service during which colleagues paid tribute to Nates outstanding career, with the inevitable humorous tales or reference to his beloved Geelong Cats. OARA arranged to video tape the memorial service and played a compilation at our Annual General Meeting. Copies of this one hour tribute are available.
Nate was our visionary and guiding light and is sadly missed by the OARA committee. However, in establishing OARA 25 years ago, the ongoing OA Data Base and the Adult Patient Review Clinic he has left a wonderful legacy which will benefit past, present and future OA/TOF patients and families.
Your OARA committee appreciates the continuing support and assistance it receives from the Neo Natal Case Managers, the Surgeons and Doctors and the Auxiliaries staff. The ongoing
interest and involvement of the wider OARA community is necessary to sustain our development and I encourage you to forward your membership/donation subscription.
Nate Myers Memorial Service VideoTo obtain your copy of the entire one hour (approx) video please forward your mailing address and your cheque for $10 made payable to OARA at PO BOX 370 BORONIA 3155. This will cover the cost of the video plus postage. |
President OARA
Professor Spencer Beasley
Report to OARA -27 October 2004
As part of our ongoing commitment to research, OARA funded a research project involving simulating OA in foetal rats. Below is the update on this research being conducted under the guidence of Professor Spencer Beasley.
"When OARA decided to support the initial work performed by Dr Qi Baoquan in Melbourne in 1995-6, using the adriamycin-induced rat model of Oesophageal Atresia, it is unlikely that the remarkable course that research has taken would have been predicted. The first studies simply involved refining the animal model so that it would more constantly produce Oesophageal atresia, and to document all the other congenital abnormalities that it produced. It has been quite astounding to see how similar the range of abnormalities that are produced in this animal model are compared with the VATER association in the human; not surprisingly, therefore, the model was soon seen as not just one for Oesophageal Atresia, but also an equally good one for all the abnormalities of the VATER association. This observation significantly expanded the opportunities for using the model to find out exactly how structural defects occurred.
When Dr Qi followed Spencer Beasley to Christchurch in 1997 he became the head scientist of the newly-formed Christchurch Hospital Paediatric Surgical Research Unit, and with Andrew Williams, Richard Pole and Vivienne du Bois they set about to study the role of the notochord in producing Oesophageal Atresia and it's related abnormalities. This is where research took an exciting turn. It had been known for many years that the notochord was primarily responsible for 'organising' the 3-D relationships of the developing foregut, including the trachea and oesophagus. What our research showed was that the more abnormal the notochord itself was the more abnormal is the oesophagus and trachea. Other research has discovered that the notochord expresses a very specific gene called sonic hedgehog. What we wondered was whether failure of the notochord to express this gene correctly (at the correct time and place) might cause Oesophageal Atresia.
This is when we employed Dejan Arsic as our PhD student. He was the person who first showed that the sonic hedgehog protein was abnormal in rats developing Oesophageal Atresia, and subsequently he confirmed that the timing and exact location of the sonic hedgehog gene expression was abnormal in those rats that were in the process of developing Oesophageal Atresia. This work took several years, as new refinements to current techniques had to be developed, and many problems had to overcome. For the first time we had a molecular biological explanation for Oesophageal Atresia. Since his pioneering work (which has received international acclaim) other groups, using a sonic hedgehog mutant mouse, have confirmed his observations in a completely different way: in this mutant mouse, which cannot express sonic hedgehog, Oesophageal Atresia and the same abnormalities occur. Now, our current PhD student, Parkash Mandham is studying whether anorectal malformations (e.g. imperforate anus) occur by the same mechanism.
But research follows a strange and unpredictable path- and this might be the most fascinating part of the whole story. Normally the sonic hedgehog pathway is active during early embryological development- that is how the oesophagus and the trachea develop. If it is abnormal, Oesophageal Atresia may result. But after the oesophagus and the trachea have been formed, the whole process is turned off, and it remains turned off for the rest of life. It should never turn on again, so the levels of sonic hedgehog are not detectable. However, if it does turn on again later in life, a cancer forms. Examples of the cancers that are due to reactivation of the sonic hedgehog pathway include some brain tumours, skin tumours and probably some other childhood tumours.
So suddenly, we find that there is a connection between the gene that allows the oesophagus and the trachea to develop (as well as other structures affected by VAATER association) and cancers that occur later on in life. Is it possible that if we can better understand why the sonic hedgehog gene expresses abnormally in Oesophageal Atresia, that we may ultimately understand also why these cancers form later on? If we can, might we eventually be able to stop them happening? If we can determine why sonic hedgehog gene expressions stops after the oesophagus and trachea have formed, then we might be able to make it stop when it is reactivated in cancers. So research that started out looking simply at Oesophageal Atresia might end up shedding light on a number of cancers as well! "
FOOTNOTE: Professor Beasley has maintained his close links with RCH through Mr Auldist, Mr Stokes and the late Mr Myers. He sent his best wishes to all involved with OARA and will keep us informed of the progress of the research.
OARA Breakfast
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On August 21, 2004 we held our first OARA breakfast and what great fun and food we all had. Approximately thirty families attended, including two families with babies still in the Neonatal unit. We were pleased that many families made the trip from country Victoria.
Kiki the Clown and her cute dogs were the hit of the day with crazy songs and funny tricks. We had many laughing, painted faces rapt in her show and also had many budding artists enjoying some plaster painting. As the children were entertained by Kiki, and other activities, the adults could relax and take the opportunity to talk to other OARA parent about their experiences and to offer support and encouragement to one another.
At the end of the morning each OA/TOF child and their siblings received a gift bag of goodies and each family received a parent pamper pack of pasta, sauce and wine. We were very fortunate to have many wonderful sponsors for our breakfast and we would like to thank the following: AAMI Insurance, Orange Hutchinson Mobile Network, Rinoldo Pasta, Leggos Simplot, Jon Casimir of the Andrew Denton Program, the Plaster Fun House Malvern, Lyle Warwick Colouring Books, Artline Markers, Essendon Football Club, the RCH Auxiliaries Office and especially, Kiki the Clown.
It was suggested that we hold a function in rural Victoria in 2005 and we would welcome any suggestions as to venues or activities. Given how much fun was had at the breakfast, and the positive feedback received, we will definitely hold a family function again next year.
Our thanks to all families who attended and helped to make it such a fun filled and happy morning. We hope to see you all again soon.
The 2004 OARA Golf Classic
The 13th Annual OARA Golf Classic, held at the Heidelberg Golf Club on Friday September 10, was again a most successful event, with a field of 78 players and a total of $ 12519.00 raised.
This excellent financial result is largely due to the input from a number of new sponsors to supplement the regular sponsors who have supported the event for many years.
OARA wishes to record its sincere appreciation to the following companies and individuals for their generosity.
| Abi Group Asset Services | John Gawne |
| Adams Platform/Media World Communications P/L |
Adam & Graeme Clark |
| RN Barr Sandblasting | Noel Barr |
| Clanbrooke Racing | Dean Humphries |
| Independent Crane Hire | Lidia Field |
| Infradig | John Graham |
| J D's Truss Company | Stephen Fisher |
| Leighton Contractors P/L | Phil cooper |
| Open Door Pub Company | Michael Thiele |
| The Coodabeen Champions | Jeff Richardson |
| Macafee Investments | The Macafee Family |
| Wridgways The Removalists | Brian Clarke |
Players in the 2004 OARA Golf Classic found the Heidelberg course challenging due in part to the heavy conditions as a result of recent rainfall and the hilly nature of the layout. However, the Heidelberg Golf Club is to be congratulated for its willing assistance to ensure that the tournament was a complete success in every way.
Sincere thanks go to Nora O'Reilly and staff of Tim Hollands Catering for the excellent meal and dining room service, Club Professional Brendan Green and staff who assisted with compiling scores, and Course Superintendent Mark Burchill, whose staff happily posted signage around the course and markers on greens.
The guest speaker at the luncheon was 15 year old Claire Miller, patient number 586 in the oesophageal atresia story at the Royal Children's Hospital in Melbourne. Claire described clearly the nature of oesophageal atresia, reviewed the problems associated with management of the condition in her early years, and discussed her current treatment for scoliosis ( a progressive curvature of the upper spine ) which requires a rod to be inserted in her spine to restrict further curvature.
When Claire detailed her involvement in gymnastics, dancing and swimming, and her plans to travel overseas in 2005 with her school, the audience was in admiration of the manner in which she has coped with illness while leading a busy, exciting and fulfilling life.
We congratulate Claire for her stimulating contribution to the success of the 2004 OARA Golf Classic, thank her for sharing her story on behalf of all Oesophageal Atresia patients, and wish her every success for the future.
A major feature of the OARA Golf Classic is the raffle, and OARA is most appreciative of member John Tunstall, of Tunstall Plant Hire (father of OA patient Shannen) and office manager Karen for their tireless work in writing letters seeking donations, and collecting and collating gifts. As a result, the 2004 raffle contained a multitude of prizes, and generated the magnificent sum of $2020 to add to the financial success of the day.
OARA thanks the following companies who provided gifts for the 2004 OARA Golf Classic raffle and showbag -
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Robert's Head to Toe Fashion
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GolfPro & Lucastrade
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Benny's Sweets
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McWilliams Wines
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Telstra
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Lowan Australia Ltd
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Cadbury Schweppes
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Kraft Foods
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Linen House Pty Ltd
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GK Travel
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Knox Tavern
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DeBortoli Wines
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St. Huberts Vineyard
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Wantirna Health & Squash Club
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Piranha Golf
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Extend Abilities
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Victorian Book Wholesalers
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Tunstall Plant Hire
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Village Cinemas
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Heidelberg Golf Pro Shop
Finally, the organiser wishes to thank the many players who participate in the Golf Classic each year, and give so generously. Regular players who were unable to attend in 2004 still sent their donation, and their support is indicative of the goodwill that exists on behalf of OARA and the Royal Children's Hospital.
Sincere thanks also go to the many OARA committee members who negotiated donations with sponsors and made donations themselves, thus ensuring that the 2004 OARA Golf Classic was a successful activity not only for OARA, but for players and sponsors alike.
The date for the 2005 OARA Golf Classic is not yet set. However, it will be played again at Heidelberg, and probably in late October or early November. We look forward to your support once more at that time.
John Graham
Organiser, OARA Golf Classic
October 2004.
A note from founding OARA committee member Di Pollard remembering Nate Myers
Dear O.A.R.A Members
I had planned to attend tonight (2004 AGM - Ed.) but alas something has cropped up and I haven't made it. Needless to say I am very disappointed. Please accept my apologies.
In 1979, when Nate and I first discussed a group for parents of children with Oesophageal Atresia and associated abnormalities, and perhaps raise some money that could be used for some form of research, it was never envisaged that the OARA of today would have evolved.
Nate was a truly wonderful, dedicated and brilliant man. He will not be forgotten. As a mother I would not have a son or granddaughter, and as a family we would not have a brother, grandson, uncle or nephew. We owe him so much.
We all know the truly wonderful things that have been achieved since OARA began, and I have to thank everyone who has contributed with their time effort and knowledge. Over the years we have seen and helped many families and some brilliant research has been achieved.
A lot of lasting and wonderful friendships have also been formed, and this can only enrich all our lives. OARA has become a part of us.
I do wish the incoming committee success and thanks the outgoing members for their contributions. Nate was always proud of everyone's achievements. I know that OARA, and all the wonderful people associated with it, will continue to do great things.
Kindest regards
Dianne Pollard
Oesophageal Atresia Review Clinic for Adults
The Adult Clinic held monthly at St. Vincent's Hospital continues to offer ongoing care or initial assessment to adult OA/TOF patients. Adults who have not visited the clinic are encouraged to do so if they are not under the care of a specialist. - at least for the initial assessment. All patients are bulk billed.
The initial busy stage is over and the clinic is now run alongside an "Oesophageal disorders clinic"
Oesophageal Atresia Clinic for Adults
St Vincent's Hospital Melbourne,
41 Victoria Parade, Fitzroy, 3065.
Phone (03) 9288 3222
Patient Profiles
Kym Columbine
OARA Patient 31 years.
For several years now I have been receiving a copy of the OARA newsletter via my parents, who have been long time supporters of OARA. I have been meaning to sit down and share my story, and I've finally got around to it.
In September 1972 I was born several weeks premature, and within hours of my birth, I was diagnosed with Oesophageal Atresia. I was transferred to the Royal Children's Hospital, under the care of Mr Maxwell Kent, where I had the first of several operations to correct the problem. For the next 4-5 years the RCH became my, and my parents, second home, from my initial stay of several months, to my return visits for the occasional dilatation and other operations not related to my OA.
I have many memories of my time at "the Children's", some good and some not so good. One memory that I don't think I'll lose is the taste of the "milkshake" I had to drink for a barium swallow x-ray -even though it has been 25 years since the last one I had. I'm sure there are many out there that would agree with me. But without the RCH, and Mr Kent, I guess I wouldn't be the person that I am today, and for that I am forever grateful.
While I wasn't the healthiest of young boys I don't think I ever let that stop me. Typical of OA patients I had reduced lung capacity and my strength and stamina were probably lower than healthy boys my age. As a result, sports weren't my thing but I still went to cubs and scouts and in my teenage years took up white water kayaking, which I continued into adulthood.
I was lucky to have parents who let me test my limits and work out on my own what I could and couldn't do. There wasn't many things they weren't willing to at least let me try. Not being sporty meant I concentrated more on my studies, and I went on to University to study a Bachelor of Applied Science in Environmental Health.
As an adult I have travelled around Australia and overseas, and my work as and Environmental Health Officer brought me to Brisbane, where I have now settled. Today I am healthy and have no long-term health problems relating to my oesophageal atresia. As long as I am careful with cutting and chewing food, and am able to have drink with each meal, I don't experience blockages or difficulty swallowing. Of course I bear the scars of my early surgery - my extra belly button and zipper on my chest, and the "bullet hole" under my shoulder blade.
Kerry Graham
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This great man has been a part of our lives since 28th May 1960, when our first child Kerry Ellen, at the age of three days, was his seventeenth successful Oesophageal Atresia operation. Kerry has been one of the great success stories of this great surgeon and, at the age of 44, has had no problems since the first year of her life. To this man and his team we are just so grateful. After arriving back in Wangaratta on June 28th 1960 Kerry had regular visits to the Royal Children's Hospital for the next twelve months. In adult life Kerry has visited the hospitals for check-ups and research purposes on at least two occasions.
Kerry attended primary and secondary schools in Wangaratta and then did her teaching training at Frankston Teacher's College, graduating in 1980. Kerry started teaching the following year and has been teaching ever since. She is currently teaching at Clarinda Primary School in Melbourne. Early in her career she spent three years at a very small school near Bendigo with only nine students. This school was a one teacher school and we believe that these children received a great education. It was a great experience for Kerry and she stayed until the closure of the school in 1986.
Kerry married in 2002 and in June will be spending her long service leave holidaying overseas with her husband Mal Candy.
We were very fortunate to have been able to attend the 'Zoo Day' with the members in 1994 and talk with Dr Myers and other Oara members. Gwenda Woolrich visited us early in the '80's when she was calling on other Oara members in the district and this was a great pleasure.
We look forward to receiving our newsletter in the future and wish members all the best for the coming years.
Baby Jesmin-Sinaitiana Lei
Jesmin was born on April 22, 2004 and admitted to the Royal Children's Hospital a day later, where her oesophageal repair was performed on July 20. Jesmin's family attended the parents function at RCH on the morning of Saturday August 21 where they proudly introduced Jesmin to all present by way of their family t-shirts displaying her picture. Jesmin was still being cared for in the hospital ward at the time.
Mother Anamaria Lei has kindly offered the following report of the impact baby Jesmin has had on the life of the family.
"Jesmin was discharged from the hospital on the 6th September, 2004 after she spent 5 months in hospital. Thank God. I breast fed her until she needed a dilatation. We'd like to thank all the Doctors and all the nurses for taking care of our daughter. May God bless you all.
Also we'd like to thank Lisa Hawley. We pray to our God for blessings on you and your family.
I had a Mothers Day card from Jesmin with her footprints on it. Also her Dad Levuka Lee Lei had a Fathers day card from her.
We thank God for Jesmin. She is an angel in our family. Also, we would like to thank the OARA committee members for this report.
May God bless you all."
Levuka Lee Lei and Anamaria Lei.
Claire Miller
Claire Miller gave a talk about her health and her life at the OARA Golf Day this year. This is what Claire related:
"I'm 15 years old and was born in February 1989 with an oesophageal atresia. This means there was no connection between my mouth and stomach in the food pipe (oesophagus). The oesophagus, which begins growing from the stomach and mouth, is supposed to join together about 6 weeks after conception, but in my case and many others, it didn't. "Atresia" basically means "dead-end". In babies with an oesophageal atresia like me, the top end of the oesophagus forms a dead-end at about shoulder height. The bottom end then usually bends over and attaches itself to the trachea (or windpipe). It doesn't take long to diagnose this life threatening condition. After birth, all the saliva a baby swallows accumulates in the dead-end, it soon spills over the top and the baby chokes. Without intervention this will cause death. No baby born with oesophageal atresia in Australia before 1949 made it past this stage. Less than an hour after my birth a Code Blue was called, and my father heard the words "I can't find any vital signs". At that point he was sure I was going to die.
As you may have guessed by now, he was wrong. Suctioning out the saliva removed the immediate danger, and the fact that the suction tube couldn't be pushed further than 10 centimetres indicated there was an atresia. Surgery is needed to reform the oesophagus. It entails cutting the dead-end off the top part of the oesophagus, disconnecting the bottom half from the windpipe, and joining the two parts together. Most oesophageal atresia babies are operated on within a day, except those with a "long gap" between the ends, who can wait months with the two ends of the oesophagus grow long enough to be able to up together.
In America in 1941, the first repair surgery for oesophageal atresia was performed. Melbourne surgeons began the surgery in 1949. I was the 586th baby at the Royal Children's Hospital to undergo the operation. Recent rates of surgery are about 20 babies per year. If all goes well, babies can go home after a week, once feeding is established. For many of these families, surgery is merely a hiccup in the post-natal period, which causes no future problems.
I spent 8 weeks at the hospital as I developed a "leak" at the operation site when small holes at the join allowed saliva to run into my lungs. I had a "chest drain" inserted into my back, draining fluid for 7 weeks. While my parents were assured this was a temporary condition, lung scarring from this fluid, pneumonia and childhood bronchitis, mean I now have only 50% of the lung capacity of girls my age, height and weight. This prevents me doing exercise that requires continual exertion - like long distance running and swimming. So I do other things. I was a competitive gymnast training up to 10 hours a week, until I as 12. I have been dancing for 11 years, and am now in a Dance Ensemble, dancing 3 hours each Friday. I occasionally attend circus-training class, where my major apparatus is acrobatics.
As well as the breathing problem, I often get food stuck at the operations site. There is no "peristalsis" there, the muscular movement that pushed food down to the stomach. This means food must be small or slippery enough to slip through the useless area. So I eat slowly, chew well and drink with all meals to "wash" down anything that is stuck. This is not a choking situation. It's just uncomfortable, and probably feels like others getting a pill stuck in their throat.
The third major condition I have is scoliosis, or curvature of the spine. This was noticed as a newborn, but didn't become prominent until I was 8. At 12 I started wearing a spinal brace, which looks and feels like a solid corset. But this hasn't stopped my back curving, and I am probably having spinal fusion within the next year.
As you may guess, I have a large medical file at the Children's Hospital. The fact that I survived and was not brain damaged was more than my parents initially hoped for. Although my medical history has caused be some problems, I've still managed to do most of the things I want to. I've danced for four years in the Rock Eisteddfod for my school, Northcote High. In December I'm participating in the Great Victorian Bike Ride, riding 560 kilometres over nine days. Next year I'm going to China with my schools Senior Concert Band, for whom I play flute. Next year I'll also begin VCE, then go to University, and eventually become a Primary School Teacher. "
Family Picnic Day
The OARA Family Picnic Day was held at Ruffey Lake Park Doncaster on 21/3/2004. This was an excellent venue which allowed the children to explore the nearby Adventure playground and with first class BBQ picnic facilities for all to enjoy. The relaxed environment allowed parents to socialize and discuss the many aspects of raising children and provided the opportunity of knowledge and support that OARA has been developing and promoting through these types of family gatherings.
Photos of the day
(L to R) Nicholas & Linda Clark, Karen Gawne,
Denise & Michael Paxino
(L to R) Denise & Michael Paxinos, Chris & Keith Wiggett,
Carlo, Gail & Liam Urrutia
(L to R) Keith Wiggett, Carlo Urrutia, John Gawne & Gail Urrutia
Rhys Rigoni
Thank you so much for the invitation to the OARA Picnic Day. Unfortunately we will be unable to attend which disappoints us. We would love to catch up with everyone and hope you keep us in mind for the next get-together.
Rhys is doing fantastically. He is a "very" energetic 15 month old toddler who is into absolutely everything. He is eating extremely well and at this early stage has had no problems. Our recent visit to the RCH went very well and his Doctor, Peter McDougall, indicated that he didn't need to see him for another year, all going well.
We also apologise for being unable to attend the
OARA meetings, but living in Wangaratta makes things a bit more difficult.
Hope everyone has a fantastic day on Sunday and trust we can catch up soon.
Kind Regards,
Denise, Greg and Rhys Rigoni
Rhys Rigoni
Tracheomalacia Study
As mentioned in our last edition, the Respiratory Medicine Department at the RCH has been undertaking a study to enhance cough effectiveness in Tracheomalacia.
Chronic lung disease is a common complication of repaired oesophageal atresia, particularly in those with significant tracheomalacia. Effective cough is essential for clearing secretions and, in those with tracheomalacia, cough flow may be impaired due to collapse of the trachea during cough. Positive expiratory pressure (PEP) is used as a physiotherapy technique but has not been used to support intrathoracic airways during coughing.
Associate/Professor Colin Robertson of the Respiratory Medicine Department has been working on a PEP device which will apply pressure/resistance to the airway whilst coughing into it, thus splinting the weakened airway and keeping the tracheal wall open and so increasing the cough efficiency and movement of secretions. OARA have assisted in the funding of this project and Professor Robertson gave a very well received review of his proposed research at the 2004 AGM in March.
He has recently provided an update parts of which are quoted below:
"After a slow start the study is now well underway. We have finally developed the methodology into a very functional system and have now completed studies on 35 children with tracheomalacia. As this was a new technique, it took a little while to develop the best way to analyze the data, but we now have a robust method which reflects the improvement in cough efficiency seen with the technique. Interestingly, I was able to find a very efficient PEP device which will be readily affordable. The results of the first 35 patients are very encouraging. Overall there is quite a significant improvement in cough efficiency for all children, but this is more obvious in those who have evidence of significant tracheomalacia on the baseline lung function testing.
I have submitted an abstract of the study for presentation to the Annual Scientific Meeting of both the American Thoracic Society and the Thoracic Society of ANZ. I am very grateful to the members of OARA for the significant contribution which has made this project possible".
OARA is very please that such a positive result has come from the assistance provided by us.
Alex Auldist
Royal Children's Hospital Gold Medal 2004
Paediatric Surgeon, Teacher, Researcher, Mentor
Alex has devoted his life to providing surgical services to children, with particular interest in Oesophageal Atresia and thoracic deformities.
He is a compassionate and caring doctor and a passionate advocate for his patients and their families. Alex is regarded as the doyen of Paediatric Surgery, loved and respected by his patients and peers. He embodies all the qualities that the Royal Children's Hospital stands for.
After Hours Emergencies
If you have concerns about your child that would normally warrant them being seen in emergency for specific TOF/OA related problems. Such as:
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Strictures/narrowing needing immediate attention
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Food becoming stuck/lodged in the oesophagus
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Problems with gastrostomy tubes - leaks, falling out, blockages and infections
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Problems with oesophagitis or gastritis needing immediate attention
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Other associated medical/surgical problems related to TOF/OA
The following course of action should be taken:-
Parents should ring the RCH main switchboard on 9345 5522 and explain that their child is a patient of whomever their primary surgeon is and that they need to speak to that surgeon regarding their child. The switchboard operator will take the parents name and number and will either page the requested surgeon, or the consultant surgeon on call, who will be one of either Alex Auldist, Keith Stokes, Russell Taylor or Joe Crameri.
The on call consultant will then call the parent directly to discuss the problem and to decide upon the appropriate course of action. This may entail arranging for the surgeon to meet the patient at the hospital or arranging for the duty surgical registrar to do that on the surgeon's behalf. During normal working hours the surgeons should always be contacted directly through their consulting rooms and secretaries.
For any other problems that are non TOF/OA related which may result in a child's admission to emergency the normal admission procedures will apply.
Subscriptions And Donations.
Your OARA committee over the years has been committed to providing funds for research on OA / TOF related conditions. All research is approved by the Royal Children's Hospital Research Foundation and, in some cases, has received worldwide acclaim. Clearly, this has assisted the treatment of the OA / TOF condition and improved the quality of life of many patients.
Since 1980 we have funded research, equipment provision and other projects totalling in excess of $300,000.00. Your financial support is important in assisting us in continuing our work. We look forward to receiving your annual subscription of $10.00 for the year 2005 and invite you to also consider a tax-deductible donation of $20.00 or more at the same time.
| Please find enclosed my/our Annual Subscription of | $10.00 |
| Plus my/our Donation of | $ |
| Total enclosed | $ |
| Name: | |
| Address: | |
| Postcode: | |
| Child's Name: | |
| Mail to: The Treasurer OARA PO Box 370 Boronia 3155 |